The provider pipeline
When a hospital system declared an emergency on youth mental health, Rotary members stepped up
The chief medical officer at Children’s Hospital Colorado had never seen anything like it. Suicide had become the leading cause of death for the state’s adolescents ages 10-18, and there were periods in 2021 when the number one reason children turned up at emergency departments was for an attempt to take their own life. Straining to meet the demand for care, the hospital’s CEO did something that had never happened at the 113-year-old institution: She declared a state of emergency.
Similar scenes were playing out around the country as the COVID-19 pandemic turbocharged the mental health crisis among America’s youth and revealed in stark terms the results of a shortage of providers.
One in 6 U.S. children over the age of 6 have a diagnosed mental health disorder. Yet, only around half of them receive adequate treatment.
Among those who took notice when the Colorado hospital system sounded the alarm were three members of the Rotary Club of Highlands Ranch, a Denver suburb. Within a year they began raising funds to confront the issue head- on. Debby Doig, Shrin Murthy, and Tamara Fennell spent more than a year crisscrossing the state to talk about youth mental health at Rotary clubs. After almost every presentation, Doig says, someone would approach them with a story.
Dressed in honorary white coats, Rotary Club of Highlands Ranch members (from left) Tamara Fennell, Shrin Murthy, and Debby Doig pose outside of Children’s Hospital Colorado. They raised $500,000 to establish the Rotary Clubs of Colorado Endowed Fellowship for Pediatric Mental Health.
Courtesy of Tamara Fennell
“They didn’t raise their hand and say this out loud, but they would come up to one of us and whisper in our ear their own personal tragedy,” Doig says. “Many times, it was suicide. Their child, their sister, their brother. I had one woman at a Rotary meeting come up and say, ‘Two weeks ago, I tried to kill myself. And if it wasn’t for Rotary, I wouldn’t be here.’”
Testaments like that shored up the trio’s commitment to an audacious goal: raising half a million dollars to fund the education of pediatric mental health specialists.
That number wasn’t even on the table in early 2021, when Murthy heard about the crisis from a speaker at the Highlands Ranch club. Among the most chilling developments, hospitals were seeing younger and younger patients come into their emergency rooms after attempting suicide.
“We’re seeing rising rates in the 5- to 9-year-old population, if you can believe it,” says Dr. K. Ron-Li Liaw, Children’s Hospital Colorado’s first-ever mental health in-chief. “Elementary school-age kids are making suicide attempts.”
A few months after the hospital declared its state of emergency, three pediatric organizations declared one at the national level. Experts aren’t entirely sure what’s driving the crisis but point to a range of causes. The pandemic isolated kids and subjected many to the trauma of losing loved ones. More than 140,000 children in the United States lost a primary or secondary caregiver or both in the first 15 full months of the pandemic.
But the number of kids attempting suicide has been on the rise for years. Between 2016 and 2022, children’s hospitals saw a 166 percent increase in emergency department visits for suicide attempts and self-injury among children ages 5-18. That’s partly because there simply aren’t enough doctors to treat troubled youths before their mental health problems become severe, says Dr. Cassie Littler, president of the Colorado chapter of the American Academy of Pediatrics. The U.S. has only 14 child and adolescent psychiatrists per 100,000 youths, and 70 percent of counties have no such professionals at all.
By the numbers
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40+
Clubs visited during the fundraising campaign
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$500K
Total raised to fund the endowment
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1,500
Number of patients a fellow can see per year
“It would make a big difference if we had behavioral health providers in pediatricians’ offices,” Littler says. “Changing how we fund prevention would go a long way, because then we could intervene and help children and families gain those coping mechanisms and problem-solving skills.”
When Murthy first heard about the issue through his club, it didn’t occur to him that he could help with the provider shortage. He just knew he wanted to take action in some way. “I said, we’ve got to do something in order to address this crisis,” he says.
Murthy and Doig formed a mental health committee within the Highlands Ranch club and began researching options. Murthy served on the volunteer board at Children’s Hospital Colorado, so he reached out to Martine Hyland, a philanthropy director at the hospital’s foundation, for advice about possible gifts. Hyland suggested different giving opportunities with a range of dollar amounts but was stunned by the one Murthy and Doig chose. They sought to fund a $500,000 fellowship to train new doctors on mental health.
“They said, ‘We want to go big. We want to endow a fellowship,’” Hyland says. “And I’ve got to tell you, I thought they were nuts. We’ve been the grateful recipients of lots of Rotary gifts from different clubs but nothing at that magnitude. I thought, ‘How are they going to do this?’”
First, Doig and Murthy recruited Fennell, a fellow club member who’d spent years working with the National Alliance on Mental Illness. They told her about the benefits of endowing a fellowship. With a $500,000 endowment, the investment income would be enough to fund education, a cost-of-living stipend, and research opportunities for a new fellow every one to two years. They’d be actively addressing the doctor shortage. And with a presence throughout Colorado, the hospital system would ensure a statewide reach.
A personal connection to the issue cemented Fennell’s support. “My mother lived with severe mental illness, bipolar disorder and obsessive-compulsive disorder,” Fennell says. “And I’ve done a lot of mental health advocacy work, so I was especially excited about working on this project.”
There was just the small matter of raising $500,000. But Fennell was galvanized, not intimidated, by that number. “When Shrin came to me and said, ‘Hey, I want to do this. What do you think about it?’ I was overjoyed,” she says. “We were actually going to make a positive impact for a countless number of kids and families in perpetuity. That’s the thing that’s so special about it — it’s not a one-off. It is a lasting legacy program.”
Fennell, Murthy, and Doig pose with Martine Hyland (far right), a philanthropy director at the hospital’s foundation, during a check presentation ceremony.
Courtesy of Tamara Fennell
Fennell, Murthy, and Doig prepared a presentation and began contacting Colorado’s Rotary clubs. The Highlands Ranch club had a foundation of its own, which donated $50,000 to get them started. Then came the grinding work of visiting more than 40 clubs all over the state.
“We went from club to club to club, and we would do our presentation. We must have driven hundreds and hundreds of miles,” Murthy says. “It was a very humbling experience to go and talk to these clubs. But then the money started coming in.”
Ultimately it took about a year and a half to raise the funds. That was three and a half years less than the hospital’s foundation usually sees when groups try to raise that much money. But Murthy was determined to act fast.
“I said to Debby and Tamie, ‘We need to wrap it up by September of 2023, so that we can have a fellow in place by the spring or summer of 2024,’” he says. “The mental health problem was getting worse every year. By putting a fellow in place as soon as possible, that person can then visit up to 1,500 patients a year. If we didn’t have a fellow in place, we would miss 1,500 people.”
Besides the money they’ve raised, Fennell notes, they’ve also spread awareness of the issue, including to Rotary clubs and districts they hope will adopt the model in other places. “I’m not going to be teaching physicians and fellows how to make their practices better — I don’t have that skill set,” she says. “But what I do have is the ability to share my knowledge of the crisis we’re in and to speak my lived experience to others.”
This story originally appeared in the May 2024 issue of Rotary magazine.